*original aricle generated on Poise.com

As women reach their 40s and 50s, they enter a time in their lives referred to as "perimenopause."  During this period, before the menopause, hormone levels start to fluctuate up and down. Lower estrogen levels, as well as fluctuating levels of estrogen, during perimenopause is what causes the symptoms of PMS (premenstrual syndrome), missed periods, mood swings, fatigue and weight gain.

When a woman no longer has a period for twelve months, she is considered to be menopausal.  In addition to the typical perimenopausal symptoms, women begin to experience hot flashes and night sweats during menopause. The further decline in estrogen can also lead to vaginal dryness and if left untreated, intercourse can become difficult and painful. It is also common during menopause for women to complain that it takes longer and require more stimulation for them to become aroused and reach orgasm.

For these reasons, it is important that women incorporate lubricants into their sexual relationships if they are experiencing vaginal dryness. This will allow them to experience more pleasure as well as avoid trauma, tears, or discomfort. I recommend that my patients use the Poise vaginal lubricant during sex. It is made without glycerin, parabens or fragrance, which is important because these ingredients can cause irritation for some women.

Additionally, as women age and enter into menopause, sexual desire may diminish because of reduced testosterone levels. While there is not an FDA-approved treatment currently available yet for women for loss of libido, doctors can formulate testosterone and prescribe it to their patients who are symptomatic and have low testosterone levels. For this reason, it is important that women feel empowered to speak openly with their health care providers about sexual health issues and concerns and advocate for themselves.

Sexual health is a critical component of general health and wellness. My goal is to help women feel comfortable communicating these concerns, which can be difficult, if not embarrassing, to discuss with their partners and their health care providers.

In addition to the physical changes that occur in our bodies during the menopause, it is also an emotionally challenging time. Aside from the body's waning production of hormones, women can also lose desire for emotional reasons. Factors like how a woman perceives the change in the appearance of her body with aging, the loss of fertility and ability to conceive, and other factors that are occurring in their lives during this tim - the empty nest, retirement, or presence of other medical health related issues - can cause a woman to have less interest in sexual activities.  The good news is, with time, patience, and the benefit of knowledge and information, the majority of menopausal women can enjoy sex, learn to relish this stage of their lives and develop a new level of intimacy with their partners.  Communication is key to maintaining a healthy sexual relationship during every stage of life.

During menopause, a healthy lifestyle is not only something we should aspire to, it's something we need to ensure and promote for ourselves and our families. The fastest and easiest way to boost self confidence and improve sexual desire is regular exercise, regular sleep, and a healthy balanced diet. While menopause marks the end of a woman's reproductive cycle, it does not signal the end of her sexuality. The popular phrase "finished at fifty" is not only a cliché, it's history. It was a saying made popular when women simply did not live as long as they do today. Now, menopause is really a time for women to feel liberated and free. My goal is to help women approach this time in their lives with knowledge, comfort and enthusiasm, as opposed to anxiety and fear.